173511 Health disparities in rural areas: The interaction of race, socioeconomic status, and geography

Sunday, October 26, 2008

Paul Campbell Erwin, MD, MPH , Professor and Director, Department of Public Health, University of Tennessee, Knoxville, TN
Eugene C. Fitzhugh, PhD , Center for Physical Activity and Health, University of Tennessee, Knoxville, TN
Kathleen C. Brown, PhD, MPH, RN , Community Assessment and Health Promotion, Knox County Health Department, Knoxville, TN
Shannon Looney, BS , Center for Public Health, University of Tennessee, Knoxville, TN
Timothy Forde, PhD, MPH , Oak Ridge Associated Universities, Oak Ridge, TN
The elimination of health disparities is one of the overarching goals of Healthy People 2010. Race as a risk factor for health disparities can be particularly evident when comparing health indicators in metropolitan areas, where there are large populations of whites, African-Americans, and other races and ethnicities. For rural areas, however, where the percentage of minority populations is very low, does race remain a measurable risk factor for health disparities, or are other drivers – such as SES – more predominant?

The purpose of this study is to examine the potential influence of race vs. SES in rural areas with a low proportion of African-Americans. Race-specific mortality data were examined for the leading causes of death, including infant mortality, for 15 rural counties in East Tennessee, where African-Americans comprise 2.1% of the population, and 1 metropolitan county, where African-Americans comprise 8.6% of the population. For the metropolitan county, 45% of African-American infant deaths would have been averted had these infants died at the same rate as white infants. For the rural counties, 29% of African-American infant deaths would have been averted had these infants died at the same rate as white infants. When counties were grouped into quartiles according to county-level poverty data, 11% of infant deaths in lower SES counties would have been averted had infants in those counties died at the same rate as infants in higher SES counties. Both race and SES remain as risk factors for health disparities in rural areas, despite the low proportion of minorities.

Learning Objectives:
1. Recognize the multiple risk factors for health disparities/health inequities, including race, socioeconomic status and geography. 2. Identify the health disparities that exist in rural areas as compared to urban areas. 3. Apply this methodology for examining “averted deaths” in other rural settings.

Keywords: Health Disparities, Rural Health

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I led the concept, design, and analysis for the work described in the abstract.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.